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Title: Critical assessment of urinary prostate cancer gene 3 (pca3) in the prediction of aggressive prostate cancer (gleason score >= 7) at biopsy
Authors: Auprich, M ×
Haese, A
De La Taille, A
Van Poppel, Hendrik
Marberger, M
Abbou, C. C
Stenzl, A
Mulders, P. F. A
Schalken, J. A
Huland, H
Stillebroer, A. B
Van Gils, P. M. Q
Fradet, Y
Marks, L. S
Ellis, W
Partin, A. W
Chun, F. K. H #
Issue Date: Mar-2011
Publisher: Elsevier science bv
Host Document: European urology supplements vol:10 issue:2 pages:207-207
Conference: EAU edition:26 location:Vienna date:18-22 March 2011
Article number: 641
Abstract: Introduction & Objectives: Recent studies demonstrated that, PCA3 represents
an important complimentary marker to established risk factors in the initial and
repeat biopsy setting. However, discrepancy remains concerning PCA3’s potential
to identify aggressive prostate cancer (PCa) at prostate biopsy.
Materials & Methods: Our cohort consisted of 1606 men undergoing initial (IBX,
n= 772) and repeat prostate biopsy (RBX, n= 834) based on an elevated PSA level
and/or suspicious DRE and/or suspicious pathological findings on previous biopsy.
We evaluated risk factors to predict aggressive PCa (HGPCa) defined as tumor
with Gleason score ≥7, respectively. Clinical variables such as age, DRE, PSA
(continuously coded and as cut-off 2.5 and 4ng/ml), %free PSA (%fPSA), prostate
volume and urinary PCA3 assay score (continuously coded and as cut-off 17,
24, 35) were analyzed. After stratification according to history of previous biopsy
uni- and multivariable logistic regression analysis to predict aggressive PCa was
performed. Uncorrected accuracy estimates were quantified using the area under
the curve (AUC) of the receiver operator characteristic (ROC) analysis.
Results: Overall PCa was detected in 39.2% (n=626) of men. Moreover, PCa was
detected in 355 (45.9%) men at initial and 275 (33%) men at repeat biopsy. At IBX
43.2% of men were detected with HGPCa. A higher age, PSA level, and PCA3
score and a suspicious DRE was significantly associated with HGPCa (all, < 0.05)
at IBX. At UVA DRE (AUC=0.68), followed by PCA3 score (AUC=0.61), was most
informative in predicting HGPCa. MVA, identified PSA and DRE as independent
predictors at IBX. At RBX 31.6% of men were detected with HGPCa. A higher PSA
level, lower %fPSA and a suspicious DRE was significantly associated with HGPCa
(all, ≤ 0.05). At UVA, PSA (AUC= 0.68), followed by %fPSA (AUC=0.61), was most
informative. Finally, MVA identified PSA as independent predictor for HGPCa at RBX.
Conclusions: Our data demonstrate that, despite patients with aggressive PCa
presented a significantly higher PCA3 score at initial biopsy, the novel urinary
diagnostic marker could not be identified as independent risk factor for aggressive
disease. Similarly, at repeat biopsy, where PSA was independently predicting
aggressive diseases, PCA3 was not predictive for PCa with Gleason score ≥7,
respectively.
URI: 
ISSN: 1569-9056
Publication status: published
KU Leuven publication type: IMa
Appears in Collections:Urology Section (-)
× corresponding author
# (joint) last author

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